Eye injuries

this is the topic of b.bsc third yr, and gnm which include all the common eye injuries, its causes and management and nursing care

1. Eye Injuries DEPARTMENT OF MEDICAL SURGICAL NURSING

2. Learning Objectives At the end of this lecture the students will be able to: Landmarks of the eye Different types of eye injuries Emergency care for eye injuries Contact lenses, and how to remove them Dental trauma Emergency care for dental injuries

3. Eye Injuries The globe of the eye, or eyeball is a sphere approximately 1” in diameter 5 most important landmarks of the eye: – Sclera – the “white” of the eye – Cornea – clear, front portion of the eye which covers the pupil. – Pupil – opening in which light enters – Iris – colored portion of the eye – Retina – back of the eye

4. Common causes of eye trauma : Blunt/penetrating trauma – Sport/recreational activities – Assaults – Chemical exposures from household products – Industrial accidents – Foreign bodies – Animal bites/scratches

5. TYPES OF EYE INJURIES Eye injuries are usually not life-threatening Time is of the essence in your treatment, – to help prevent any visual disturbances and disruption 6 different types of eye injuries: – Foreign object in the eye –

6. Injury to the orbits – Lid injury – Injury to the globe – Chemical burn to the eye – Impaled object/ Extruded eyeball

7. Foreign Object in the Eye Dust, dirt, sand, or fine pieces of metal can be blown or driven into the eye and lodged there • A flow of tears washes out many of these substances before any harm is done • A patient with a foreign object in the eye, will complain of feeling the object, and the globe will appear red

8. Emergency Care for a Foreign Object in the Eye • Flush the eye for at least 20 minutes • If you cannot flush the eye, and the object is from the white of the eye, try to remove the object • Ask the patient if they have made any attempt in removing the object – possibly causing an abrasion to the cornea

9. To remove the object: Pull down the lower lid while the patient looks up, or pull up the upper lid while the patient looks down, remove object with sterile gauze If unable to remove, cover both eyes with bandages

10. Injury to the Orbits Trauma to the face may result in the fracture of one or several bones that form the orbits of the eyes • Injuries serious enough to cause orbital fractures, may also cause a cervical spine injury

11. Lid Injury • Lid injuries include bruising, burns, and lacerations • Lid injuries can cause profuse bleeding • Anything that lacerates the lid, can also cause damage to the eyeball

12. Emergency Care for a Lid Injury • Control bleeding with light pressure • Do not use pressure if the eyeball itself may be injured • Cover lid with sterile gauze soaked in saline to keep wound from drying • Preserve any avulsed skin, and transport it with the patient for later grafting • If eyeball injury is not suspected, cover injured lid with a cold pack to reduce swelling • Cover both eye’s to decrease movement

13. Injury to the Globe • Injuries to the globe include bruising, lacerations, foreign objects, and abrasions • Globe injuries should be treated with great caution! • Emergency Care: – Apply patches to both eye’s – Do not apply pressure if you suspect a ruptured eyeball – Pressure can force the eye contents to leak out

14. Chemical Burn • Chemical burns to the eye represents a DIRE emergency • Permanent damage can occur within seconds • The first 10 minutes following an injury often determines the final outcome • REMEMBER: Burning and tissue damage will continue to occur as long as any substance is left in the eye… even if that substance is diluted

15. Chemical Burn Signs and Symptoms: – Irritated, swollen eyelids – Redness of the eye – Blurred/diminished vision – Excruciating pain in the eye’s – Irritated, burned skin around the eye’s

16. Emergency Care for a Chemical Burn • Immediately begin irrigation with water or saline – It need not be sterile, but should be clean • Hold eyelids open so all chemicals can be washed from behind the lids • Continuously irrigate for a Minimum 20 minutes • Remove contact lenses – may trap chemicals • Remove any solid particles from the surface of the eye Wash your hand’s afterward…Prevent contamination to yourself!

17. Irrigation of a Chemical Burn

18. Impaled Object & Extruded Eyeball • Impaled or embedded objects in the eye should not be removed • Your job consists of stabilizing the object to prevent accidental movement or removal • NEVER attempt to replace the eye in the socket!!

19. Impaled Object & Extruded Eyeball Emergency Care • Immobilize the head and spine • Encircle the eye and impaled object/extruded eyeball with a gauze dressing • Do Not apply pressure! • Stabilize embedded object with a cup or dressings – Impaled object/extruded eyeball should not touch the sides, or the top of the cup * Make sure to bandage both eyes to prevent movement

20. Stabilizing an Impaled Object & Extruded Eyeball

21. Contact Lenses • Eye injuries are often complicated by the presence of contact lenses • To detect lenses, shine a pen light into the eye – A soft lens will show up as a shadow on the outer portion of the eye – A hard lens will show up as a shadow over the colored portion of the eye (iris) • Some patient’s only wear contact lenses in one eye, so make sure to check both eyes • Some patient’s wear both contact lenses and eye glasses (elderly) • You should remove contact lenses if there is a chemical burn to the eye • Do Not remove contact lenses if the eyeball is injured

22. Soft Contact Lenses • Soft contact lenses are designed for extended wear, but can cause damage if left in for a long time • Over time, they can gradually dehydrate and shrink, making removal difficult

23. You can remove Soft contact lenses with the following method: – Middle finger tip on lower lid – pull lid down – Place index finger tip on lower edge of lens – slide lens down

24. – Compress lens between your thumb and index finger – allowing air to get underneath it and remove it from the eye – If lens is dehydrated on the eye, run sterile saline across the eye surface – pinch it up to remove it

25. Summary So far we have discussed about definition, types, emergency care. Dental trauma, how to remove contact lens in eye injuries

26. Bibliography Lewis et al, Medical Surgical Nursing, Mosby Elsevier,7 th edition. Joyce.M.Black et al, Medical Surgical Nursing, Saunders publication. Brunner and Siddhartha, Medical Surgical Nursing, Lippincott Williams and Wilkins.

27. Thank You